AB1645 CONTRACEPTION IN WOMEN WITH IMMUNE-MEDIATED INFLAMMATORY DISEASE
Authors: S. Rodriguez-Muguruza, S. Castro Oreiro, M. J. Poveda, N. Del Castillo, M. Menacho, G. Valldosera, M. Just, N. Mohino, R. Fontova
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Given that teratogenic medications prescribed to women with immune-mediated inflammatory disease (IMID) may cause significant fetal harm, the use of effective contraception is crucial in reproductive-age women receiving potentially teratogenic medications. <h3>Objectives</h3> To determine: Relationship between potentially teratogenic drugs and the efficacy of contraception methods. The prevalence of contraceptive methods in women of reproductive age with IMID. <h3>Methods</h3> Cross- sectional study (May 2021 - May 2022). All women of reproductive age with an IMID (rheumatology, dermatology and gastroenterology external consultation) were invited to participate. Patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, psoriasis, Crohn's disease and ulcerative colitis were included. Patients with hysterectomy, primary or secondary amenorrhea were excluded. A self-administered questionnaire including questions on the use of contraceptive methods was administered. Medications prescribed for IMID were identified and assigned a pregnancy risk category (according FDA): Class A - B (safe to use during pregnancy), C (have not been adequately studied to assign a pregnancy classification) and D-X (potentially teratogenic, their use is relatively/ absolutely contraindicated during pregnancy). For women who were prescribed multiple drugs, we assigned their FDA risk category based on their drug with the highest potential teratogenicity. Contraceptive methods were also classified according to their relative effectiveness (based on World Health Organization (WHO)) (Table 1). When women had more than one contraceptive method we classified according to their most effective method. Our analysis categorizes drugs as either A/B/C or D/X, ("low risk" vs "high risk"). To determine the relationship between the potential teratogenic drug and the effectiveness of contraceptive method we used Chi-square tests. <h3>Results</h3> A total of 59 women participated (Table 2), mean age 41.2 (SD ± 6.8) years. Contraceptive use was referred by 41 (69.5%) of the patients (Table 1): 56.1% (23 patients) used a method classified as moderately effective, 31.7% (13) as highly effective and 9.8% (4) as ineffective. Of women with teratogenic drugs: 37.5% (15 patients) did not use a contraception method or it was considered as ineffective. The relationship between potentially teratogenic drugs and effectiveness of contraceptive methods has a P value of 0.668 (Table 3). <h3>Conclusion</h3> The prevalence of contraception methods in reproductive-age women with IMID is about 70%. In women who used a contraceptive method, contraception considered to be ineffective was the least frequent. We found no relationship between the risk of teratogenicity in drugs prescribed for IMID and the effectiveness of contraceptive method. <h3>References</h3> [1]Hunt N. Family Planning and Rheumatoid Arthritis. Curr Rheumatol Rep. 2019;21:16 [2]Leverenz DL. Contraception methods used by women with rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol. 2019;38:1207-12 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.